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Individual

MR. PHILLIP R STEVENS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
#3 STONECREST DRIVE, HUNTINGTON, WV 25701
(304) 522-6388
(304) 522-8040
Mailing address
#3 STONECREST DRIVE, HUNTINGTON, WV 25701
(304) 522-6388
(304) 522-8040

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
15360
WV
207Y00000X
Otolaryngology Physician
30789
KY
207Y00000X
Otolaryngology Physician
35078614S
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0101200000
WV
05
0698759
OH
05
64697220
KY
Enumeration date
03/01/2006
Last updated
06/06/2008
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